The article analysed the availability of healthcare services in terms of assumptions and implementation of the act “hospital network”. The aim of the research was to try to answer the question about the impact of the creation of a hospital network on the availability of healthcare. The provisions of the act and implementing acts were analysed, as well as the effects of the reform, including: the structure of the hospital network, the number and value of healthcare services, the degree of performance by hospitals of contracts with the NFZ, waiting time for healthcare services and the number of people waiting, the degree of use of hospital beds, expenditure on healthcare, the financial situation of hospitals. The summary concluded that the creation of a hospital network did not increase the availability of healthcare services. It was the result of the failure to take into account epidemiological and demographic conditions and insufficient funding. The situation does not cross out the legitimacy of the creation of a hospital network, but it points the direction of further reforms.

Personel medyczny to podstawowy element systemu ochrony zdrowia. Organizacja systemu, w tym poziom i struktura zatrudnienia oraz profesjonalizm kadry medycznej są, obok czynników genetycznych, środowiskowych oraz stylu życia, istotnymi determinantami zdrowia społeczeństwa. Celem polityki zdrowotnej powinno być dążenie do zapewnienia równości w zdrowiu, poprzez minimalizowanie różnic w poziomie zdrowia oraz w zasięgu, dostępie, korzystaniu, jakości i użyteczności opieki zdrowotnej pomiędzy grupami ludności, zróżnicowanymi pod względem dochodów, wieku, płci, narodowości, pochodzenia etnicznego, miejsca zamieszkania [Golinowska, 2012, s. 191].Sektor ochrony zdrowia jest jednym z największych obszarów gospodarki Unii Europejskiej. Zatrudnia ok. 17 mln osób, co stanowi 8% pracujących w UE. Wydatki na ochronę zdrowia w państwach członkowskich wynoszą od 5,9% PKB w Rumunii do 12% PKB w Holandii [Buchan, Wismar, Glinos, Bremner, 2014, s. 55]. Wskaźniki te świadczą o wysokich całkowitych nakładach na ochronę zdrowia, ale nasuwają również przypuszczenie istnienia nierówności w zdrowiu pomiędzy krajami członkowskimi UE, co potwierdzają analizy demograficzne. Wskaźnik oczekiwanej długości życia, który jest obiektywnym miernikiem badania nierówności w stanie zdrowia, wynosi w UE 79 lat, od 74 w Bułgarii, Rumunii, Litwie i Łotwie do 83 lat we Włoszech (Polska 77 lat). Wskaźnik oczekiwanej długości życia w dobrym zdrowiu wynosi 70 lat, od 65 lat na Litwie i Łotwie do 74 lat na Cyprze (Polska 67 lat). Pomiędzy krajami

No abstract

The aim of the study was to assess the diversification of the degree of innovation in the Polish regions. For the analysis 21 partial indicators were used, these were grouped into four areas describing the level of innovation in each region (framework conditions, investments, innovative activities, influence). The data was taken from the European Innovation Scoreboard 2021. Hellwig’s development pattern method was used in the research. A ranking was created based on the synthetic variable, and typological groups of regions were extracted with a similar development level in each of the assessed areas. The results obtained from organizing and classifying individual voivodeships showed the distance between individual voivodeships with regard to the examined criteria, and allowed for the creation of a qualitative and quantitative description of the existing disproportions. The most innovative region in Poland is the statistically separate Warsaw capital district. At the same time, the difference between the rest of the Mazowiecki region and its capital is clearly visible, as well as the necessity to further concentrate European Union resources there in order to stimulate the development of the region. Among the leaders of innovation, apart from the Warsaw district, are the Małopolski, Pomorski, and Dolnośląski regions. The Podkarpacki region holds a relatively high position in the areas of investment, innovative activities and influence (concerning employment, selling innovative products and sustainable development), and is situated to the second (II) group. On the other hand its weakness include its framework conditions (human capital, attractive research systems and digitalization). The lowest level of innovation was recorded in the aforementioned Mazowieckie region (excluding Warsaw), and in the Świętokrzyski, Zachodniopomorski, and Warmiński-mazurski regions. Each voivodeship is distinguished by its specificity, hence the obtained results may constitute important indicators for local governments to adopt courses of action to stimulate the process of building regional innovation systems.

Purpose – The purpose of the paper is to examine the relationship between the organisation of the state (determined by selected characteristics, i.e. the organisational structure model and the position of the SNG sector) and the organisation of the health care system, and an indication of the possible consequences for the sustainability of public finance. Research method – The author uses a method of descriptive analysis and the analysis of statistical data on health care expenditure in 12 EU Member States with an insurance model of health care. The quantitative analysis was based on the latest available statistical data (2017) from the OECD, the WHO and Eurostat databases (according to ICHA and SHA2011). Results – It was concluded that despite the legal separation and theoretical independence from the budget system, the insurance model of health care may pose a threat to the sustainability of public finance. This applies both to the state budget and the SNG sector, which is particularly vulnerable in countries where the decentralisation of public services is not accompanied by an appropriate design of the financing system. Originality /value / implications /recommendations – This paper discusses the problem of the compatibility of the health care system and state organisation, omitted in literature, including the position of the SNG sector, in the context of fiscal sustainability.